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CMS Conducts Star Ratings Best Practices Webinar

Written by Roy Albert

CMS hosted a webinar yesterday focusing on best practices for Medicare Advantage and Prescription Drug Plan Sponsors looking to enhance their Star Ratings. As described in our previous blog posts, Star Ratings assist enrollees in choosing Medicare Advantage Plans and Prescription Drug Plans, and have played an increasingly important role in Plan Sponsors’ payments and marketing and enrollment efforts.

In opening remarks, CMS noted that Plan Sponsors with 5 Star contracts may sign up enrollees during a Special Enrollment Period, which allows enrollees to switch to a 5 Star plan once from December 8 through November 30.  CMS also cautioned that beginning in 2015, CMS plans to terminate contracts that receive the “Low Performing Icon” for failing to achieve at least 3 Stars for three consecutive years.

Panel discussions and presentations from representatives of high-performing Medicare Advantage and Prescription Drug Plan Sponsors served as the basis for the majority of the webinar.  Sessions included Creating a Culture of Quality in Your Organization, Identifying Effective Uses for Information Technology, Developing Innovative Approaches to Member Outreach and Education, Conducting Successful Provider Relations, Closing Gaps in Care, and Improving Beneficiary Satisfaction and Retention.

Health plan representatives described approaches they have taken to create a culture of quality, to establish quality-based frameworks, and to use various capabilities to make improvements when administering care.  Many of the presenters highlighted innovative outreach techniques they have implemented to engage patients and enhance member satisfaction.  Presenters also focused on their organizations’ goal to meet the “triple aim” framework developed by the Institute for Healthcare Improvement (IHI):  (1) improving the patient experience of care (including quality and satisfaction); (2) improving the health of populations; and (3) reducing the per capita cost of health care.

The webinar provided a valuable opportunity for Plan Sponsors and their first tier, downstream, and related entities to hear first-hand about initiatives taken by some of the organizations that CMS considers to be the highest performers.  The materials from the webinar are available here.


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Roy Albert